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目的:比较血液净化和血液净化联合依达拉奉治疗急性百草枯中毒的临床效果。方法:回顾分析35例急性百草枯中毒患者,按照是否接受依达拉奉治疗分为对照组和试验组。对照组17例,接受血液净化治疗;试验组18例,接受血液净化联合依达拉奉治疗。将各组的生化指标、并发症情况、预后进行比较。结果:治疗前,两组患者的生化指标差异均无显著性(P>0.05),治疗后,试验组患者肌酐(Cr)(110.7±27.9)μmol/L、WBC(12.0±3.4)×10~9/L、丙氨酸氨基转移酶(ALT)(26.0±4.1)IU/L、PaO_2(88.2±15.1)mmHg,其中Cr、WBC均明显低于对照组治疗后(P<0.05);试验组发生呼吸衰竭、急性肾功能衰竭和心衰的例数分别为4、7、3例,均明显少于对照组治疗后(P<0.05);试验组死亡患者的平均存活时间为(10.3±5.2)d、治愈率27.7%、好转率38.9%、病死率33.3%,均明显优于对照组(P<0.05)。结论:血液净化能够较快的清除毒物,依达拉奉能清除氧自由基,抑制细胞的氧化损伤,二者联合治疗能起到保护重要脏器、改善预后、降低并发症的目的,是急性百草枯中毒患者较好的治疗方法。
OBJECTIVE: To compare the clinical efficacy of blood purification and blood purification with edaravone in the treatment of acute paraquat poisoning. Methods: A retrospective analysis of 35 patients with acute paraquat poisoning, according to whether the treatment of edaravone is divided into control group and experimental group. Control group of 17 cases, receiving blood purification treatment; 18 cases of experimental group, receiving blood purification combined with edaravone treatment. The biochemical indicators of each group, complications, prognosis were compared. Results Before treatment, there was no significant difference in biochemical indexes between the two groups (P> 0.05). After treatment, creatinine (Cr) was (110.7 ± 27.9) μmol / L, WBC was 12.0 ± 3.4, 9 / L, ALT (26.0 ± 4.1) IU / L and PaO_2 (88.2 ± 15.1) mmHg, respectively. Cr and WBC were significantly lower than those in the control group (P <0.05) The number of cases with respiratory failure, acute renal failure and heart failure were 4, 7 and 3 cases, respectively, which were significantly less than those in the control group (P <0.05). The mean survival time of the patients who died in the experimental group was (10.3 ± 5.2) ) d, the cure rate was 27.7%, the improvement rate was 38.9% and the case fatality rate was 33.3%, which were significantly better than the control group (P <0.05). Conclusion: Blood purification can quickly remove toxic substances. Edaravone can scavenge oxygen free radicals and inhibit oxidative damage of cells. The combination of the two can protect important organs, improve prognosis and reduce complications. It is acute Paraquat poisoning patients better treatment.